Patency of superior ciliary sulcus in aphakic silicone oil-filled eyes: an ultrasound biomicroscopy study

Objective: To assess the patency of the superior ciliary sulcus in aphakic silicone oil-filled eyes by ultrasound biomicroscopy (UBM).Design: Prospective interventional series.Participants: Twelve eyes of 12 patients were included in this study.Methods: Twelve aphakic silicone oil-filled eyes were evaluated using UBM. The UBM examination of the anterior segment was performed using the Humphrey Instruments UBM equipped with a high-frequency (50 MHz), high-resolution (50 mm) transducer. The patients were placed in a semisitting position in which their backs were inclined to a suitable angle (about 50°). They were also asked to look straight ahead, to bring the superior ciliary sulcus to the highest point of the globe. The probe approached the patients' eyes superiorly at a slight angle (about 10°). Images of the superior ciliary sulcus were captured and analyzed.Results: The UBM images demonstrated an intact curved aqueous-silicone oil interface that appeared at some distance from and not filling the ciliary sulcus. A patent superior ciliary sulcus was thus found in all patients, even in those with a widely opened ciliary sulcus.Conclusions: The superior ciliary sulcus maintained its patency in aphakic silicone oil-filled eyes. These findings indicate that an iridectomy in a superior position may also be effective, although this has not been tested clinically in this report.     

Stem cells: a source for neuron repair in retinal disease

Several features of the eye make it an excellent candidate for cell-based therapy to treat corneal and retinal degenerative disease. Corneal and retinal stem cells have been identified in the adult human eye. Advances in the stem cell field, including methods for cell purification, culture, and molecular characterization, have made it easier to manipulate eye stem cells. Moreover, delivery, sequestration, tracking, and measurement of outcomes of transplanted cells are both feasible and easier for the eye than for other tissues. These factors, together with our understanding of the molecular pathways that regulate eye development, have resulted in promising results in transplantation of cells to the cornea and retina. While there is certainly reason for cautious optimism, several obstacles remain before this will ever be a clinical reality, including identification of the most appropriate source of stem cells, the long-term efficacy of cell transplantation in the context of ongoing disease, and the potential of transplanted cells to give rise to tumours.     

Edinger-Westphal and pharmacologically stimulated accommodative refractive changes and lens and ciliary process movements in rhesus monkeys

During accommodation, the refractive changes occur when the ciliary muscle contracts, releasing resting zonular tension and allowing the lens capsule to mold the lens into an accommodated form. This results in centripetal movement of the ciliary processes and lens edge. The goal of this study was to understand the relationship between accommodative refractive changes, ciliary process movements and lens edge movements during Edinger-Westphal (EW) and pharmacologically stimulated accommodation in adolescent rhesus monkeys. Experiments were performed on one eye each of three rhesus monkeys with permanent indwelling electrodes in the EW nucleus of the midbrain. EW stimulated accommodative refractive changes were measured with infrared photorefraction, and ciliary process and lens edge movements were measured with slit-lamp goniovideography on the temporal aspect of the eye. Images were recorded on the nasal aspect for one eye during EW stimulation. Image analysis was performed off-line at 30 Hz to determine refractive changes and ciliary body and lens edge movements during EW stimulated accommodation and after carbachol iontophoresis to determine drug induced accommodative movements. Maximum EW stimulated accommodation was 7.36+/-0.49 D and pharmacologically stimulated accommodation was 14.44+/-1.21 D. During EW stimulated accommodation, the ciliary processes and lens edge moved centripetally linearly by 0.030+/-0.001 mm/D and 0.027+/-0.001 mm/D, with a total movement of 0.219+/-0.034 mm and 0.189+/-0.023 mm, respectively. There was no significant nasal/temporal difference in ciliary process or lens edge movements. 30-40 min after pharmacologically stimulated accommodation, the ciliary processes moved centripetally a total of 0.411+/-0.048 mm, or 0.030+/-0.005 mm/D, and the lens edge moved centripetally 0.258+/-0.014 mm, or 0.019+/-0.003 mm/D. The peaks and valleys of the ciliary processes moved by similar amounts during both supramaximal EW and pharmacologically stimulated accommodation. In conclusion, this study shows, for the first time, that the ciliary processes and lens edge move centripetally, linearly with refraction during EW stimulated accommodation. During pharmacological stimulation, the ciliary processes move to a greater extent than the lens edge, confirming that in adolescent monkeys, lens movement limits the accommodative optical change in the eye.     

正常人眼球后动脉血流动力学参数相关性研究

目的：应用彩色多普勒成像技术（Color Doppler Imaging,CDI)对正常人视网膜中央动脉、睫状后动脉与眼动脉血流参数的相关关系进行研究。方法：应用CDI技术测量30例（60眼）正常人视网膜中央动脉（central retinal artery,CRA)、睫状后动脉（posterior ciliary artery,PCA)及眼动脉（ophthalmic artery,OA)的各段血流动力学参数。分析CRA、PCA与OA血流参数及OA段间血流参数关系。结果：CRA、PCA与OA各相应血流参数间均存在明显正相关关系（P＜0．05）。OA各部位相应血流参数间亦存在明显线性关系（P＜0．01）,并可建立直线回归方程。结论：应用CDI技术分析球后各动脉血流参数间的相互关系,对临床眼血流动力学研究具有重要的意义。     

原发性睫状体前旋型青光眼

为探讨原发性睫状体前旋型青光眼的临床表现和UBM对此型青光眼的诊断价值。方法：选择2例经UBM确诊为睫状体前旋型青光眼患者,比较了其临床表现和UBM的形态特征,并与1例睫状体位置正常的发育性青光眼比较。结果：证实UBM检查可明确地显示睫状体前旋型青光眼的形态特征。结论：UBM对原发性睫状体前旋型青光眼有重要的鉴别诊断意义。     

抗青光眼手术对原发性开角型青光眼血流动力学的影响

目的 探讨原发性开角型青光眼（primary open-angle glaucoma,POAG）眼血流动力学变化,观察抗青光眼手术对眼血流动力学的影响。方法 利用标准化彩色多普勒成像（color Doppler imaging,CDI）技术检测POAG患者16例20眼手术前后的眼球后血流状态。结果 抗青光眼术后视网膜中央动脉和睫状后短动脉血流速度较术前明显提高,血流阻力下降。结论 抗青光眼术后眼血流可得到改善,有益于保护视功能。CDI检测技术应标准化,实现检测结果的可比性。     

Multifocal chorioretinal atrophy associated with Herpes zoster ophthalmicus

A 73‐year‐old woman developed multiple depigmented lesions in the fundus 4–6 months after an episode of acute Herpes zoster ophthalmicus. Post‐mortem examination of the globe 15 years after this acute episode confirmed multiple old chorioretinal scars probably due to vasculitis of the short posterior ciliary arteries and branches. Patchy old infarcts were also noted in the iris.     

In vitro neuroprotective effects of ciliary neurotrophic factor on dorsal root ganglion neurons with glutamate-induced neurotoxicity

Ciliary neurotrophic factor has neuroprotective effects mediated through signal transducer and Janus kinase (JAK) 2/activator of transcrip-tion 3 (STAT3) and phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathways. Whether ciliary neurotrophic factor is neuroprotective for glutamate-induced excitotoxicity of dorsal root ganglion neurons is poorly understood. In the present study, the in vitro neuroprotective effects of ciliary neurotrophic factor against glutamate-induced excitotoxicity were determined in a primary culture of dorsal root ganglion neurons from Wistar rat embryos at embryonic day 15. Whether the JAK2/STAT3 and PI3K/Akt signaling pathways were related to the protective effects of ciliary neurotrophic factor was also determined. Glutamate exposure inhibited neurite outgrowth, cell viability, and growth-associated protein 43 expression and promoted apoptotic neuronal cell death, all of which were reversed by the administration of exogenous ciliary neurotrophic factor. Additionally, preincubation with either JAK2 inhibitor AG490 or PI3K inhibitor LY294002 blocked the neuroprotective effect of ciliary neurotrophic factor. These data indicate that the two pathways JAK2/STAT3 and PI3K/Akt play major roles in mediating the in vitro neuroprotective effects of ciliary neurotrophic factor on dorsal root ganglion neurons with glutamate-in-duced neurotoxicity.     

双轴线外部标记控制缝线人工晶状体定位精度的临床研究

目的　探讨双轴线外部标记技术在睫状沟缝线固定人工晶状体植入术中的定位效果。方法　无晶状体眼２７例（２７ 眼）接受经巩膜缝线固定人工晶状体植入术,双轴线外部标记技术控制两条子轴线:子轴线１:精确选定等距、对称的巩膜穿刺位点,使角膜中心点投影位于巩膜穿刺位点形成的固定轴线即子轴线１上;子轴线２:精确选定等距、对称的线襻结合位点,使人工晶状体光学中心点位于线襻结合位点形成的固定轴线即子轴线２上。术后随访６～２４个月,平均１０．８个月。通过测量人工晶状体光学中心点偏位度及超声生物显微镜（ｕｌｔｒａｓｏｕｎｄｂｉｏｍｉｃｒｏｓｃｏｐｅ,ＵＢＭ）全景测量固定位点轴向人工晶状体倾斜度和与固定位点轴向垂直的轴向人工晶状体偏转度判断人工晶状体位置精度,同时观察可能发生的并发症。结果　人工晶状体光学中心点与角膜中心点高度重合者２５眼（９２．６％）,偏离角膜中心点者２眼（７．４％）,偏位幅度为（０．２３±０．０４）ｍｍ;ＵＢＭ全景测量角巩膜缘２－８位点轴向人工晶状体倾斜度为（０．２０±０．０４）°;ＵＢＭ全景测量与角巩膜缘２－８位点轴向相垂直的１１－５轴向人工晶状体偏转度为（０．２４±０．０３）°;４眼（１４．８％）单襻位于位于睫状沟旁,６眼（２２．２％）双襻位于睫状沟旁,人工晶状体光学中心均保持居中;全部病例未发生人工晶状体缝线松解、人工晶状体脱位、角膜失代偿等并发症。结论　双轴线外部标记技术具有整体、直观、便捷的技术特征,具备精确控制缝线人工晶状体定位的可行性。